| NPI | 1447505656 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA M WILKINSON Owner 317-710-0354 |
| Organization Subpart ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: PA MF000668) |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2012-07-13 |